Managing Provider Roles in Medical Care

ABSTRACT

Techniques for managing provider roles during medical are are supported. A system may include a central medical information management system that maintains information regarding ongoing treatment of patients, which can track medical professionals assigned to the patients. Medical professionals may use mobile devices to access and display the information regarding assigned case roles and may further use the mobile devices to coordinate assumption and handoff of roles.

RELATED APPLICATIONS

This application claims the benefit under 35 U.S.C. §119(e) of U.S.Provisional Application Ser. No. 61/182,686 filed May 29, 2009.

TECHNICAL FIELD OF THE INVENTION

The present invention relates generally to managing medical data, andmore specifically to managing medical case and chronology informationfor one or more medical practices.

BACKGROUND OF THE INVENTION

Many medical care establishments use and share medical case informationbetween medical professionals. For this purpose, medical professionalsmay use various physical files, written displays, and electronicsystems. For example, many anesthesia care locations use a white boardto track patients being treated. Many medical professionals alsodocument progress through medical procedures using forms or otherpaperwork. Such documentation may be used to record events duringpatient treatment and generate invoices.

SUMMARY OF THE INVENTION

In accordance with the present disclosure, an apparatus, method, andsystem for managing provider roles in medical care is provided whichsubstantially eliminates or reduces disadvantages and problemsassociated with previous systems and methods.

According to a particular embodiment, a handheld apparatus is providedwhich includes a user interface having a display and capable ofreceiving user input, a wireless network interface coupled to a centralmedical information management system, a memory for maintaining amedical information management application and a user profile having auser identifier, and a processor capable of executing the medicalinformation management application. The central medical informationmanagement system maintains a collection of patient tracking records forpatients receiving care. Each of the patient tracking records includes apatient identifier, medical personnel assignments indicating one or moreassigned medical providers for those records with assigned personnelalong with a caregiver role for each assigned medical provider, and casestatus information indicating a current state of the care for thepatient. The medical information management application can display alist of the patient tracking records received from the medicalinformation management system, identify a patient tracking records basedon user input, display indications of the caregiver roles, and receive arole selection for the selected patient tracking record based on userinput, where the role selection indicates a desire to assume one of thecaregiver roles for the selected patient tracking record. Theapplication can further communicate the role selection and the useridentifier to the medical information management system and receive aninformation update from the medical information management system. Theinformation update reflects that the medical information managementsystem has updated the assigned medical providers for the selectedpatient tracking entry to reflect the role selection.

Particular embodiments provide various technical advantages. Thesetechniques provide wide-spread sharing of case information betweenmedical professionals of an anesthesia, surgical or other medical teamwithout requiring medical professionals to use a common physical caseboard. In addition, techniques of the present disclosure provide updatesto case status as they occur, at or near the time of correspondingchanges in the field. Moreover, case supervisors or other managers nolonger need to check a physical case board or physical location (such asa holding room or operating room) to determine case status.

Particular embodiments provide wide-spread access to medical event data,such as anesthetic or surgical events, thereby sharing information thatwould otherwise be limited to the few people with physical access to acorresponding paper form for the medical event. Such techniques may alsofacilitate proactive medical, resource, and manpower management. Thesetechniques may also enable simultaneous access by other teamprofessionals who may be spread throughout a particular location or evenat other remote locations.

Particular embodiments provide case status alerting. These techniquesfacilitate targeted case status alerting that requires neither acallback nor the multicast of alert messages to all medicalprofessionals. Such techniques also facilitate automatic case statusalerting without any requirement that the user actively request casestatus. Thus, important case status information can be sent toappropriate medical professionals allowing them to take appropriateaction, such as making a necessary physical location visit.

Particular embodiments may facilitate secure authentication and login toa medical information management system. Techniques for secure login canmaintain secure access procedures while eliminating or substantiallyreducing the use of long usernames and passwords that introduce delayand complexity to those seeking access to the system using a mobiledevice that may have constrained user input capabilities. Such securelogin techniques also provide authenticated access to medicalprofessionals through external networks not located at a health carefacility.

Particular embodiments may facilitate the entry of patient and case dataitems. These techniques allow checklist data to be immediatelysearchable through appropriate information systems. Such techniques alsoeliminate transcription error associated with paper-based patient andcase data and alleviate possible legibility issues. Additionally, thesetechniques facilitate the automatic entry of related case items and/oridentify data elements that are in conflict. Moreover, such techniquescan present or record data elements that may have been overlooked by amedical professional but were appropriate for the medical care rendered.

Particular embodiments may facilitate assuming case roles andhanding-off case roles between medical professionals. These techniquesaccurately record the time associated with case roles and caserole-handoff. Such techniques may further enable case roles and anysubsequent changes to case roles to be communicated to all medicalprofessionals of a team, thereby eliminating confusion and any patientcare difficulties.

Other technical advantages of the present invention will be readilyapparent to one skilled in the art from the following figures,descriptions, and claims. Moreover, while specific advantages have beenenumerated above, various embodiments may include all, some, or none ofthe enumerated advantages.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a block diagram illustrating a system environment withelements that interoperate to manage and display medical caseinformation;

FIG. 2 is a block diagram illustrating an example medical informationmanagement system for facilitating management of medical caseinformation;

FIG. 3 is a block diagram illustrating an example embodiment of ahandheld device for executing a medical information managementapplication for displaying and tracking medical case information;

FIG. 4 is a system architecture diagram describing an example userinterface for a medical information management application operating ona handheld device;

FIG. 5 illustrates an example system hierarchy of a graphical userinterface on a handheld device;

FIG. 6 illustrates an example case board interface presented on ahandheld device for interacting with a medical information managementsystem;

FIG. 7 illustrates an example patient treatment interface for displayingpatient treatment information for a specific medical case;

FIG. 8 is a block diagram illustrating an example case alert system forsending, processing, and transmitting case alerts to users of a medicalinformation management system;

FIG. 9 illustrates an example process flow for secure authentication,login, and access to a medical information management system;

FIG. 10 illustrates an example process flow for conducting role-handoffsbetween users of a medical information management system; and

FIG. 11 illustrates an example case summary interface for summarizingcase details and facilitating role-handoffs between medicalprofessionals using a medical information management system.

DETAILED DESCRIPTION OF THE DRAWINGS

FIG. 1 is a block diagram illustrating a system 100 with elements thatinteroperate to manage and display medical case information. Theelements of system 100 can support a number of different operations,including maintaining a central, unified repository of patient and caseinformation for one or more practices, facilitating maintenance anddisplay of a graphical case board, enabling entry and display of patienttreatment records including case chronology information, facilitatingcase status alerting in conjunction with tracked medical cases,providing an intuitive graphical user interface for interacting with thesystem, facilitating entry of medical case information, enablingelectronic tracking of medical case assignments and roles in addition totechniques for assuming new assignments and roles and passingassignments and roles between users, and establishing secureauthentication and access techniques to facilitate medical caseinformation management functions.

Medical professionals can use the medical information and functionalityof system 100 to manage one or more cases for a particular medicalpractice with one or more practice locations. Users of system 100 caninclude medical professionals and associated staff, such as surgeons,anesthesiologists, other physicians, certified registered nurseanesthetists (CRNAs), hospital management, billing personnel, medicalrecord managers, and any other medical staff Under appropriatecircumstances, system 100 may further provide patients access toselected information. According to particular embodiments, system 100may be used to manage information for one or more medical practices. Amedical practice is any organization of associated medical professionalsand associated personnel, such as a group of doctors and support staffwith a common specialty that potentially practice at one or moredifferent practice locations, a group of doctors and support staffassociated with a particular hospital, or any other suitableorganization of medical professionals. For example, an anesthesiapractice may include anesthesiologists, CRNAs, and other support staffthat practice at a set of particular medical treatment facilities.

In the illustrated embodiment, system 100 includes a number of elementsinterconnected by various networks, including a communications network102, a wireless telephony network 104, a local area network 106, and awireless network 108. Networks 102, 104, 106, and 108 representcommunications equipment, including hardware and any appropriatecontrolling logic, for interconnecting elements and facilitatingcommunication between these elements. Communications network 102 mayinclude local area networks (LANs), metropolitan area networks (MANs),wide area networks (WANs), any other public or private network, local,regional, or global communication network, enterprise intranet, othersuitable wireline or wireless communication link, or any combinationthereof. Communications network 102 may include any combination ofgateways, routers, hubs, switches, access points, base stations, and anyother hardware, software, or a combination of the preceding that mayimplement any suitable protocol. For illustrative purposes, system 100is also shown as including other specific types of networks, includingwireless telephony network 104, local area network 106, and wirelessnetwork 108. The use of these or similar networks facilitate seamlesscommunication between components of system 100 regardless of theirgeographic location or communication protocols.

As illustrated, system 100 includes a wireless telephony network 104coupled to communications network 102. Wireless telephony network 104represents communications equipment, including hardware and anyappropriate controlling logic, for interconnecting elements andfacilitating communications by wireless devices. Wireless telephonynetwork 104 may include gateways, call managers, routers, hubs,switches, access points, base stations, cellular towers, radio networks,satellite telephone equipment implementing appropriate protocols forwireless telephony communications. While only one wireless telephonynetwork 104 has been illustrated, it should be understood that variousembodiments may operate using more than one wireless telephony network.In addition, various embodiments may incorporate wireless telephonynetworks 104 in other networks of system 100 such as, for example,wireless network 108.

The illustrated embodiment of system 100 also includes a local areanetwork 106 coupled to communications network 102. Local area network106 represents communications equipment, including hardware and anyappropriate controlling logic, for interconnecting elements within alimited network area (as compared with, for example, wide areanetworks). Local area network 106 may include any combination ofgateways, routers, hubs, switches, access points, base stations, and anyother hardware, software or combination thereof using suitable protocolsto support communications. For example, local area network 106 may bethe established network infrastructure deployed at a particular hospitalor other medical facility. While only one local area network 106 hasbeen illustrated, it should be understood that various embodiments mayoperate using multiple local area networks 106. In addition, variousembodiments may incorporate local area networks 106 in other networks ofsystem 100.

System 100 also includes wireless network 108 coupled to communicationsnetwork 102. Wireless network 108 represents communications equipment,including hardware and any appropriate controlling logic, for wirelesslyinterconnecting elements and facilitating communication between otherelements of system 100. For example, wireless network 108 may operateaccording to one or more of the 802.11 standards promulgated by theInstitute of Electrical and Electronic Engineers (IEEE). Wirelessnetwork 108 may include any combination of gateways, routers, hubs,switches, access points, base stations, wireless telephone systems andany other hardware, software, or combination thereof. While only onewireless network 108 has been illustrated, it should be understood thatvarious embodiments may operate using multiple wireless networks 108. Inaddition, various embodiments may incorporate wireless networks 108 inother networks of communications network 102.

These networks interconnect other elements of system 100, includingmobile phones 110, a billing system 112, personal computers (PCs) 114,patient information system 116, mobile devices 118, and a medicalinformation management system 120. It should be understood that whilesystem 100 is illustrated as including specific types of networks,various embodiments may operate using any suitable arrangement andcollection of networks that enable appropriate communications.

Mobile phones 110 represent portable hardware and appropriatecontrolling logic for providing telephony and/or advanced data services.For example, mobile phones 110 may support voice and datacommunications. Mobile phones 110 may include smart phones capable oftransmitting and receiving multiple forms of media including but notlimited to still audio, text messages, video, images, and content fromdisparate services. As illustrated, mobile phones 110 may be coupled towireless telephony network 104 and capable of communicating to othercomponents of system 100. According to particular embodiments, system100 may use mobile phones to provide alerts or other information tomedical personnel.

Billing system 112 represents hardware, appropriate controlling logic,and data associated with billing for medical services. For example,billing system 112 may be a computer server designed to manage billingfor a particular medical practice, such as an anesthesia practice.Billing system 112 may be network accessible to facilitate communicationwith other elements of system 100.

Personal computers (PCs) 114 represent general-purpose computers,including appropriate hardware, controlling logic, and data that may beused to interface with other system components such as billing system112, patient information system 116, mobile devices 118, and medicalinformation management system 120. For example, PCs 114 may beworkstations, laptops, netbooks, tablet computers, personal dataassistants (PDAs), or any other suitable computing device. PCs 114 maysupport a wide variety of operations such as web browsing, wordprocessing, and managing business data. According to particularembodiments, PCs 114 provide access, potentially through web-basedinterfaces, to information managed by other elements.

Patient information system 116 represents suitable hardware components,controlling logic, and data for managing patient information, such aspatient demographic information, medical histories, and/or otherrelevant medical information such as practice employees and workschedules. For instance, patient information system 116 may be embodiedin a computer system or a network of computers, which are capable ofmaintaining patient information such as patient identifiers, caseidentifiers, surgery types, date-of-birth, surgery schedule, operatingroom, attending surgeon and/or anesthesiologist, insurance information,medical history, and other patient-specific information as appropriatefor various aspects of a medical practice. Some embodiments of thepresent disclosure may include a patient information system 116 deployedat a medical practice or other medical care facility, while otherembodiments may include a global patient information system 116 formaintaining patient information. As illustrated, patient informationsystem 116 may be coupled to a network, such as local area network 106,to facilitate communication to other elements of system 100. While onlyone patient information system 116 is shown, it should be understoodthat various embodiments may include multiple appropriately deployedpatient information systems 116.

Mobile devices 118 represent any suitable portable hardware, includingappropriate controlling logic and data, capable of communicating withremote devices to facilitate management of medical information. Forexample, mobile devices 118 may include, but are not necessarily limitedto, mobile telephones, advanced (“smart”) phones, personal digitalassistants (PDAs), wireless handsets, notebook computer systems, andtablet computer systems. According to particular embodiments, mobiledevices 118 include wireless devices with advanced user interfaces, suchas the APPLE iPhone, iPod Touch, or iPad.

Medical information management system 120 represents any appropriatecombination of hardware, controlling logic, and data for managingmedical information and supporting interactive access to that data frommultiple remote (and potentially highly mobile) devices. For example,medical information management system 120 may include a networked serveror collection of networked servers, or could include in one or morevirtual servers capable of acquiring computing resources on-demanddepending on the dynamically determined needs of the system. Usingvirtual servers, medical information management system 120 could bescaled dynamically based on system requirements and real-time usage,without limiting operation to a particular physical computer serverhaving fixed computing resources. This could facilitate the scalability,efficient operation, high availability, and cost effectiveness of thesystem. As illustrated, medical information management system 120couples to networks, such as communications network 102, to facilitatecommunication to other elements of system 100.

Particular embodiments are designed to operate in a network environmentthat facilitates the retrieval and presentation of medical data to endusers, facilitating real-time tracking of medical professional activityrelated to the provision of patient care (events tracked at or near intime to the actual provision of patient care) provided at a medicalfacility such as a hospital or other medical care establishment.Systems, methods, and software exemplified in the present disclosure mayincrease the coordination of patient care, enhance the reliability ofmedical information, and help ensure the accuracy of medical recordkeeping and billing.

In operation, elements of system 100 operate together to perform variousmedical information management functions including but not limited tomaintaining a central, unified repository of patient and caseinformation for one or more practices, facilitating maintenance anddisplay of a graphical case board, enabling entry and display of medicalprofessional activity information and patient treatment informationhaving case chronology information, facilitating case status alerting inconjunction with tracked medical cases, providing an intuitive graphicaluser interface for interacting with the system, facilitating entry ofmedical case information, enabling electronic tracking of medical caseassignments and roles in addition to techniques for assuming newassignments and roles and passing assignments and roles between users,and establishing secure authentication and access techniques tofacilitate ease-of-use and other medical case information managementfunctions.

For example, medical information management system 120 is capable ofmaintaining a central, unified repository of patient, medicalprofessional activity, and case information for one or more medicalpractices. For example, medical information management system 120 maymaintain patient treatment records that dynamically track care providedto patients for one or more medical practices. Medical informationmanagement system 120 can dynamically update this information based oncommunications with medical personnel using mobile devices 118 (or othersuitable access devices). Medical information management system 120 mayalso access and exchange information with other information managementand processing elements of system 100. In particular embodiments,medical information management system 120 acquires patient managementinformation from one or more patient information systems 116. Forexample, medical information management system 120 can upload patientinformation for all patients scheduled for treatment on a particularday.

Medical information management system 120 maintains information onpatients and medical professional activity and supports interactionswith other devices to manage and display the medical and logisticsinformation. For instance, mobile devices 118 can access medicalinformation management system 120 to download information for display inthe form of a graphical case board showing all cases mapping to aparticular medical practice or even a particular location for a medicalpractice. In certain implementations, mobile devices 118 may present themedical case board information in tabbed interfaces with tabscorresponding to predefined phases of care for a medical practice.Mobile devices 118 could further interface with medical informationmanagement system 120 to receive and manage more detailed patienttreatment information through other specialized interfaces, such as acase summary interface for summarizing information for a case or a casedetails interface for detailing the chronology and other medical eventsassociated with a case. For example, mobile devices 118 may present agraphical user interface showing patient treatment records in tabbedinterfaces with the ability to list medical events for real-timetracking of cases. Users of mobile devices 118 can use these interfacesto provide real-time entry of information corresponding to treatmentevents, which medical information management system 120 can then use toupdate the case board and progress patients through phases of treatment.This type of process uses the capture of treatment information (such asbillable events or other required records) to feed other processes that,in typical systems, require separate efforts to track, such as a casewhite board that requires case board runners to physically update.

Particular embodiments support secure access to medical informationmanagement system 120 using an access scheme designed to maintain a highlevel of security while supporting user-friendly access with devicesthat may have limited or non-traditional user interfaces. The accesstechniques may use a combination of authorization information checked inone or more steps, such as a username, password, quick access code (suchas a personal identification number (PIN) or other string of charactersor gestures), secure hash, device identifiers, or other secureauthentication information. In certain embodiments, secureauthentication is a multi-step process that uses different types ofinformation provided at different stages of access. According toparticular embodiments, one step may involve device identification. Forexample, a particular mobile device 118 may have a secure device hash orother suitable unique identifier that can be registered with andverified by medical information management system 120. Another step mayinvolve a secure token or key that uniquely maps to a particular medicalpractice (which may use information from other steps, such as a securedevice hash that links a specific mobile device 118 to a particularmedical practice). Another step may involve providing a user name andassociated password, for example, by selecting a user name from a listof available users and then providing a password that meets certainlength and character requirements. Another step may require entry of aquick access code, such as a four or six number pin or a particularpre-recorded gesture. These different steps and secure authenticationinformation may be combined and used at particular times to ensure thataccess to medical information is suitably restricted while allowingauthorized users of mobile devices 118 relatively easy access toinformation. For example, after requiring one or more relativelyhigh-security authentication steps, subsequent access over the course ofsome period of time may only require a subset of credentials, such as aquick access code. During that period of time, mobile device 118 couldenter sleep modes or other application and, upon a user wishing torestart access to medical information, mobile device 118 would simplyrequire reentry of the quick access code. If mobile device 118 wererestarted or some extended period of time passed, system 100 couldrequire reprocessing through one or more of the higher security steps.

After access is granted, the user may select a practice location from alist of available practice locations for the medical practice andthereby gain access to the corresponding medical case information andfunctionality of the system. Following authentication, mobile devices118 and medical information management system 120 may interoperate topresent medical information in an intuitive graphical case boardinterface to the user. For example, the graphical case board may enableentry and display of a patient treatment record including casechronology, case status alerting in conjunction with tracked medicalcases, electronic tracking of medical case assignments and roles,assuming new assignments and roles, and passing assignments and rolesbetween users.

The graphical user interface allows medical professional activity, caseboard information, and patient treatment records to be securely accessedand displayed. In addition, this information can be used to trackbilling-related events as a patient progresses through various medicalevents or sub-events of a particular surgery or other medical procedure.For example, mobile devices 118 may securely present a graphical caseboard to view the status of a patient scheduled for a medical procedure,where medical information management system 120 actually maintains allof this information. Similarly, PCs 114 may securely access medicalinformation management system 120 to view similar information. Thus, forinstance, an interface available at PCs 114 may display patientinformation or medical events maintained by medical informationmanagement system 120, portions of which may be indirectly derived fromother components of system 100 such as patient information system 116 orone or more mobile devices 118.

In addition to viewing medical case board information in a graphicalcase board interface, embodiments of the present disclosure facilitatethe presentation and tracking of patient treatment records forparticular cases. A patient treatment record represents any collectionof information (or subset of that information) detailing informationabout a patient and the patients case(s). For example, a patienttreatment record could include general demographic information for thepatient (name, age, medical history, etc.) and case specificinformation, such as assigned or current treatment rooms (e.g., andassigned operating room), a chronology of treatment events, codes,involvement by specific medical personnel, notes, and other suitablecase information.

A patient treatment record may be accessed to display a graphicalrepresentation of a sequence of steps or medical events corresponding tothe chronology of a medical procedure for a particular case. For thispurpose, a patient treatment record may include a time record associatedwith each step or medical event corresponding to a case chronology.Thus, medical personnel may view and track billing-related events suchas the performance of a step in a medical procedure. For example, ananesthesiologist may track the time spent attending to a patient oradministering anesthesia by recording anesthesia start and stop using agraphical user interface on mobile devices 118. The entry of theseevents can feed other aspects of the system, such as the tracking ofpatients on electronic case boards.

System 100 may also use a set of case checklist items and patientinformation to track cases, including non-time specific billinginformation, procedure and diagnostic codes, and information on generalquality of care rendered by one or more medical professionals. In asimilar fashion, other events and checklists may be incorporated intothe graphical user interface to implement a set of institutionalpolicies and procedures for delivering patient care as required at aparticular medical practice or facility. The listed medical events andcase checklist items can be based on customized templates, potentiallycustomized for individual practice locations, such as for a specifichospital.

In addition to tracking medical cases, embodiments of the presentdisclosure may use medical information from medical informationmanagement system 120 to manage medical case assignments and roles amonga team of medical professionals. For example, a medical professional mayuse features provided in a graphical user interface on mobile device 118to handoff or take over a medical role. In an anesthesia setting, thismay involve a first CRNA who is actively providing care for a patienthanding-off this management role to a second CRNA when the first CRNArequires a break. Another example may include an anesthesiologist who issupervising multiple CRNAs handing-off his supervisory role to anotheranesthesiologist when he can no longer act in that capacity. Inparticular implementations, the role-handoff process may require thatthe relieving party initiate the role-handoff process to take-over acase role from another medical professional. Moreover, this role-handoffprocess may work within constraints established by institutionalpolicies and procedures for a particular facility or collection offacilities. For example, supervising anesthesiologists may be prohibitedfrom relieving other anesthesiologists when they are already supervisinga maximum of four CRNAs. Similarly, CRNAs may be prohibited fromrelieving other CRNAs when they are already providing care for anotherpatient. Medical information management system 120 may maintain a set ofrole handling rules that define permitted roles for classes of medicalpersonnel, limits on those roles (e.g., only supervise up to four cases,and not while performing any procedure), and details for how handoffsmust be processed and verified.

System 100 may further provide case alerting functionality that enablestargeted messaging to appropriate medical professionals using a varietyof communication techniques and protocols. Case alerts may occurautomatically or may be user-initiated. Additionally, case alerts maytake on a variety of forms including voice, text, multimedia, orapplication specific (e.g., embedded notification in a customer medicalinformation management application running on mobile devices 118). Inthe case of automatic notifications, case alerting schemes may deliveralerts or notifications on the occurrence of some predefined case event.Case alerts can be sent to a variety of individuals and can based onvarious roles including medical case role, team management role, orcontext-based role such as those who respond to specific clinicalchanges

In one example, supervising anesthesiologists may be alerted on theircorresponding mobile device 118 by medical information management system120 when a particular event occurs for a case for which they areresponsible. Another case alert may involve supervisinganesthesiologists being alerted when a patient transitions from onepredefined phase of care to another, such as from a pre-operation phaseto intra-operation phase. Case alerts may also be used in conjunctionwith role-handoffs. For example, medical information management system120 may notify one or more supervised CRNAs when a role-handoff resultsin a change to their supervising anesthesiologist.

Case alerts may also be delivered on disparate networks. For example,medical information management system 120 may deliver a case alertmessage or notification via communications network 102 and wirelesstelephony network 104 to mobile phones 110. Thus, certain embodimentsmay allow a medical professional to be notified of changes occurring inthe field in the form of voice, text, or multimedia messages even afterleaving the associated medical facility. In conjunction with case alertsand notifications, users receiving alerts may confirm delivery and/orissue an appropriate response. Thus, for example, mobile phones 110 mayreceive a case alert and send one or more responsive messages to medicalinformation management system 120 and/or mobile devices 118 deployed ata particular medical facility through the coordination of medicalinformation management system 120 and networks 104, 102, and 108.Therefore, medical professionals can use case alerts and notificationsto stay apprised of real-time changes occurring at a medical facility,assess the requirements for immediate patient care, and coordinate withother medical professionals to respond as medically appropriate.

Elements of system 100 may also facilitate coordination with a billingsystem 112 to develop invoices and reports. For example, medicalinformation management system 120 may communicate with one or morebilling systems 112 to support billing-related functions. Thus, medicalinformation management system 120 can support billing systems 112 toproduce appropriate invoices for surgical procedures, anesthesiaservices and/or other billing-related medical events corresponding to amedical provider site (e.g., a particular hospital or hospital floor) orindividual patients. Billing system 112 may then forward invoices orother billing information to the appropriate insurance provider,patient, or other responsible party. Thus, a billing system may beseamlessly integrated with other functionality described in thisdisclosure to perform various medical billing operations.

While system 100 is illustrated as including specific componentsarranged in a particular configuration, it should be understood thatvarious embodiments may operate using any suitable arrangement andcollection of components capable of providing functionality such as thatdescribed.

FIG. 2 is a block diagram illustrating a system 200 representing anexample embodiment of medical information management system 120 whichhas elements that interoperate to facilitate the management of medicalcase information. The elements of system 200 can support a number ofdifferent operations including maintaining a central unified repositoryof patient and case information for one or more practices, which permitsthe maintenance of case board information, patient treatment records,and case summary information. The elements of system 200 may alsofacilitate case status alerting in conjunction with tracked medicalcases and the graphical display of a user interface for interacting withthe system and the entry of medical case information from one or moredevices such as mobile phones 110, PCs 114, and mobile devices 118. Inaddition, system 200 may facilitate the management of medical caseassignments and roles and enable the assumption of new assignments androles and passing assignments and roles between members of a medicalcare team. System 200 further is operable to establish secureauthentication techniques to facilitate secure access to medicalinformation management functions and data.

System 200 represents any appropriate combination of hardware,controlling logic, and data. For example, system 200 may be one or morecomputer servers or virtual computer servers capable of providing theappropriate functionality for centrally managing patient and caseinformation for one or more practices. As illustrated, system 200includes a web server 200, a case alert module 204, a database 206, astandards-based application programming interface (API) 208, businesslogic 210, and one or more processors 212.

Web server 202 represents any appropriate combination of hardware,controlling logic and data for interfacing with remote devices usingweb-based protocols to provide web-based access to the medicalinformation and functionality provided by system 200. For example, webserver 202 may be a web host that serves web pages to facilitate accessto some or all functions of system 200.

Case alert module 204 represents any appropriate combination ofhardware, controlling logic, and data for facilitating case statusalerting in conjunction with tracked medical cases and activities of amedical care team. In addition, case alert module 204 may be coupled toone or more networks such as a telephone network, a wired or wirelesscomputer networks, a cellular network, a radio network, a satellitenetwork, or any other appropriate network capable of delivering casestatus alerts.

Database 206 represents any appropriate combination of hardware,controlling logic, and data for maintaining patient information, caseinformation, medical professional activity information, and othersystem-related data. As illustrated, database 206 has various datacomponents including patient data, case data, user data, practice data,system metadata, location data, device registry data, user access logs,and rules data.

Patient data includes information regarding patients tracked by system200. For example, for each patient tracked by system 200, database 206may maintain a patient identifier (such as a name), general demographicinformation (such as the patient's date-of-birth), and any appropriateresponsible party or insurance information.

Case data represents a collection of information corresponding to aparticular case associated with a scheduled medical procedure for apatient at a defined medical facility. Such information may include acase identifier or reference, information on a procedure scheduled tooccur or currently occurring (such as surgery type), an assignedoperating room, the attending physician or anesthesiologist, records ofthe case chronology of a scheduled medical procedure, various medicalevents in the case chronology, involvement by specific medicalprofessionals, procedure and diagnostic codes, modifiers, and audit logscorresponding to various medical events entered by specific practicepersonnel. According to particular embodiments, system 200 updates casedata based on real-time inputs from mobile devices 118. System 200 canprovide patient treatment records to other devices based on informationmaintained in patient and case data.

User data represents a collection of information corresponding tovarious users who interact with system 200, including users of PCs 114,mobile phones 110, and mobile devices 118. Such user information mayinclude authentication data such as authorized users corresponding to adefined practice location, each authorized user's passwords, eachauthorized user's system access history, each authorized user's usagepreferences, and other access codes. This information can be used toprovide secure access to system 200 and as appropriate, prohibitunauthorized access to medical information maintained by system 200.

Practice data represents practice wide settings and preferencescorresponding to a medical practice and, potentially, for one or morespecific practice locations. This may include rules and policies formanaging medical data instituted by a particular medical practice.Practice data may also include a core set or subset of medical procedureterminology for a medical practice or procedure. Such medical procedureterminology may conform to Current Procedural Terminology (CPT) orInternational Classification of Diseases (ICD) codes. Such codes may beused in conjunction with recording billing-related events for aparticular practice. Practice data may also include information relatedto historic utilization and appropriate future allocation of medicalprofessional resources available to the practice. Other informationincluded in practice data may include billing report preferences,billing export preferences, and any translation or transmission settingsnecessary to communicate various reports to the defined medical practiceat a particular location. This information facilitates the generation ofbilling reports and invoices in the desired format for a practice.

Location data includes information corresponding to a defined practicelocation, either tied to a particular medical practice at that locationor based on rules of information about multiple medical practices thatmay provide care at that location. Location data may include casechronology templates, checklist templates, quality control templates(such as a physician quality reporting incentives (PQRI) template), andother templates for capturing information in a form customized to aparticular practice location or practice location/medical practicespecified manner. These templates facilitate the recording of medicalevents occurring in the field, in addition to facilitating the real-timetracking of quality control measures. For example, a case chronologytemplate may define a set of rules regarding entry of medical eventsassociated with a procedure and include time events or other entries.Case chronology templates may be manually and/or dynamically adjustedbased on operations at one or more practice locations, such as based onfeedback showing a particular event that consistently must be manuallyentered at a particular practice location.

Rules data defines permitted or prohibited activities correspondinggenerally to users, medical professional roles, specific medicalpractices, locations, medical procedures, or other activities. Forexample, these rules may implement practice-specific orlocation-specific policies affecting medical professionals or relevantmedical events. For example, a rule for an anesthesia practice mayprohibit an anesthesiologist from managing more than four CRNAs. Thusthese rules provide guidelines for active case management in terms of aworkflow that can be specific to a medical specialty or a medicalfacility.

Standards-based API 208 represents hardware, appropriate controllinglogic, and data for interfacing with remote components usingstandardized processes and protocols. For example, standards-based API208 may interface with patient information systems 116 to retrievepatient information from one or more medical practices. As anotherexample, standards-based API 208 may facilitate interactions with remotedevices to support alerting functions, such as through text messagingwith mobile phones 110.

Business logic 210 represents hardware, controlling logic and dataassociated that controls the fundamental operation and administration ofsystem 200, including interactions of elements to provide theinteractive medical information management processes described herein.For example, business logic 210 may be software for execution by one ormore processors to provide a central medical information managementservice that tracks medical professional activity and patient care, andinterfaces with mobile devices 118. Processor 212 represents one or morecomputer processors for executing business logic 210 or other softwareor controlling logic associated with elements of system 200.

In operation, elements of system 200 operate together to perform variousfunctions of the present disclosure, including maintaining a central,unified repository of patient and case information for one or morepractices and facilitating the maintenance of medical professionalactivity information, patient treatment information including casechronology, and medical case summary information. System 200 uses thisinformation to support applications on mobile devices 118 that caninterface with and graphically present that information. In addition,system 200 facilitates case status alerting for tracked medical cases,providing an intuitive graphical user interface for interacting with thesystem and enabling the electronic tracking of medical case assignmentsand roles and medical case role-handoffs between assigned medicalprofessionals. Elements of system 200 can ensure that users of system200 are securely authenticated prior to accessing medical informationand case management functions. Accordingly, only those users who areproperly authenticated may interact with system 200.

For example, elements of system 200 are operable to maintain a central,unified repository of patient and case information for one or moremedical practices. In particular, processors 212 may execute appropriatebusiness logic 210 to communicate with one or more patient informationsystems 116 to retrieve patient information corresponding to a medicalpractice. System 200 stores information in database 206, generatesday-of-care information (for example, based on patient informationretrieved from one or more patient information systems 116),communicates information from database 206 to computing devices (e.g.mobile phones 110, PCs 114, and/or mobile devices 118), and receivesupdates, including real-time information, from one or more computingdevices. This information can then be used by a graphical user interfaceto display and facilitate real-time data entry and management of medicalcase and chronology information. Any changes occurring at thesecomputing devices that are relevant to real-time case management andmedical professional coordination may then be received over a network.Accordingly, elements of system 200 interact with one another toactively manage medical case information as patients receive care.

As discussed above, system 200 may impose various authenticationrequirements before permitting access to functions and information ofsystem 200. These may include one or more levels of interactiveauthentication steps requiring user interactions as well as ongoing,automated exchanges. For example, each communication or request from aparticular mobile device 118 may include a secure device hashidentifying that mobile device 118 to system 200.

According to particular embodiments, system 200 implements a multi-levelaccess scheme that requires different types of credentials at eachlevel. For example, system 200 could require a user name and password(potentially in combination with a device hash) for first-level accessand then a quick access code for second level access and for re-accessover some period of time. System 200 may compare these received valueswith stored user data according to business logic 210 to determinewhether the user identified in the request has appropriate credentialsfor accessing the medical information and functionality of system 200.Using these secure authentication means, system 200 can guarantee thataccess to case information and specific patient medical data isappropriately protected.

During operation, system 200 provides medical information, such as caseboard, medical professional activity, or patient treatment information,for presentation and use by graphical user interfaces presented onmobile devices 118. To support this functionality, system 200 maintainsreal-time tracking information for patients receiving care, andactivities of identified medical professionals, provides the informationto mobile devices 118, and receives and processes requests to update theinformation. For responding to medical case board information requests,case data for multiple cases may be accessed for retrieving a subset ofthe case details for forwarding to the remote computing device todisplay on its graphical user interface. For example, in response to acase board request from mobile device 118, system 200 may compileselected information for all patients scheduled to or receiving care ata practice location for a medical practice associated with therequesting mobile device 118 and then provide that information to therequesting mobile device 118, for example, as a collection of patienttreatment records.

Mobile devices 118 may also request information or provide updates forparticular cases. In response, system 200 may provide responsive patienttreatment records that include details of the requested patient and caseextracted from database 206 (potentially with more information than forcase board requests). The accessed case data may include medicalprofessional activity data relative to the case, procedure information,diagnosis information, case chronology data such as medical eventsassociated with a particular case and any related checklist items. Asappropriate, system 200 may log requests or other access events in theaccess logs of database 206 according to business logic 210 and anycorresponding rules maintained in the rules data of database 206.

In responding to information requests, system 200 may process theresponse information as appropriate based on the requesting computingdevice. Such processing may include formatting the case board or patienttreatment record according to location data in database 206. Forexample, case board information may be arranged according to a templatethat may organize all cases for a location into categories correspondingto predefined phases of care defined in the location data for a specificpractice. For an anesthesia or other appropriate practice thosepredefined phases of care may correspond to schedule, pre-operation,intra-operation, and post-operation phases. As another example, aspectsof a patient treatment record may be organized according to an eventchronology template, a modifier checklist template, and/or a qualitycontrol template defined in the location data. Thus, the templates andother information in the location data of database 206 instructprocessor 212 and business logic 210 how a practice wishes the requestedinformation to be populated, organized, and delivered for subsequentpresentation on a graphical user interface of a requesting computingdevice. However, some or all of the customization and formatting ofinformation may be handled by other elements, such as mobile devices118.

In addition to facilitating the display of chronological stages at oneor more remote computing devices, system 200 can also receive real-timeupdates corresponding to specific billing-related events such as theperformance of a step in a medical procedure. According to particularembodiments, some or all of these may be “real-time,” that is, providedfrom care-givers as (or very nearly in time to) a patient receiving careindicated by an update. For example, an anesthesiologist may use mobiledevice 118 to track, in real-time, time spent with a patient or timespent actually administering anesthesia from start to finish. Suchdurational information may be provided to system 200 and maintained inan appropriate time record of a patient treatment record. Updates mayalso include specific checklist items corresponding to events having notime value, or policy-based requirements of a medical procedure. Once anupdate is processed, other computing devices may securely receive caseinformation including these updates in the form of case boardinformation, patient treatment records, case alert, or other appropriateform. In this manner, all medical professionals associated with the casecan be kept aware of any changes occurring in real-time for a particularcase.

In operation, system 200 may also manage medical case assignments androles among a set of medical professionals. In particular, a medicalcase may include multiple roles corresponding to responsibilities ofvarious medical professionals with respect to a specific case. Incertain embodiments of the present disclosure, a medical professionalmay use features provided at their respective computing device to assumea role or handoff a medical role to another medical professional. Suchhandoffs may be necessary for shift changes, breaks, or for any othernumber of practical reasons. To facilitate the assumption of roles androle-handoff, system 200 may receive a request to handoff the role froma relieving party. In particular implementations, requiring therelieving party to initiate the role-handoff ensures that a case is notinadvertently abandoned when a role-handoff is not successful. Forexample, if the party seeking relief from a case were to initiate therole-handoff, a situation may arise where the relieving party refuses toaccept the role or is otherwise unable to accept the role and the casemay be abandoned altogether. If, however, the relieving party wererequired to initiate the role-handoff process, the role for that casecontinues to remain assigned to the party seeking relief until therole-handoff is in fact successful.

In response to a role assumption or role-handoff request, system 200 mayaccess rules data found in database 206 to determine whether the rolechange is permitted for this particular practice. Checking against suchrules ensures that policies specific to a medical specialty or facilityare properly implemented. For example, as a matter of institutionalpolicy, an anesthesia practice may prohibit the role-handoff of a casefrom one anesthesiologist to another if the relieving anesthesiologistis already supervising more than four cases as outlined in the rulesdata of database 206. As with all other events, system 200 may log therequests and subsequent role changes. In some embodiments, system 200may facilitate role-handoff coordination between medical professionalsby seeking appropriate approvals prior to a role-handoff. For example,if a relieving party initiates the role-handoff process, then system 200may seek approval from the party that would be relieved through aconfirmation or other appropriate message. Likewise, if a party seekingrelief initiates the role-handoff process, then system 200 may seeksimilar approval from the relieving party. If a role change isappropriate and finalized, system 200 updates the case data to indicatethe successful assumption or role-handoff for the case. This case updatecan then be accessed by other computing devices and/or systems such thatthey are made aware of the role-handoff in real-time. In particularimplementations, this change in case data may cause computing devicesassociated with the practice or case to receive a real-time update inthe form of case board information, patient treatment record, casealert, or any other appropriate form for receiving case updates.

During operation, system 200 may also provide case alertingfunctionality to notify medical professionals of relevant medical eventsor concerns. According to particular design considerations, case alertsmay be automatically generated or user-initiated. For automatic casealerts, system 200 is operable to maintain a list of customizable eventsfor which a case alert should be issued. In particular, database 206 mayinclude a set of alert rules specifying alerts, rules for triggering analert (such as occurrence of a particular event), and alert executioninformation (such as contact information and procedures for handling atriggered alert). Subsequent events, such as updates to case data canthen trigger case alerts. For example, an event trigger may require allrole-handoffs for a case to notify the party being relieved and/orsupervising medical personnel. Once an event trigger is associated witha medical event in the case data, subsequent events matching the eventtrigger can cause the case alert module 204 to notify the medicalprofessional indicated in the event trigger in the form of a case alert.

Case alert module 204 may send a alert messages using any appropriateformats and protocols, including voice, text, or multimedia messages,based on the targeted device. As discussed, the form and network fordelivering a case alert may be defined by the contact information of theevent trigger. For example, the contact information may indicate that asupervising medical professional wishes to be notified of relevantrole-handoffs in the form of a text message using a short messageservice (SMS) network. In certain implementations, case alert system 204may support interactive case alerts. For example, in addition tonotifying particular medical professionals of successful role-handoffs,case alert module 204 may facilitate the role-handoff process byallowing medical professionals to accept, decline, and confirmrole-handoffs. Accordingly, embodiments of the present disclosuresupport configuring, sending, and receiving automatic case alerts forcommunicating medical events to medical professionals.

Case alert module 204 can also process user-initiated messages. Forexample, a user of a particular mobile device 118 may choose to alertother users to a particular event or information. Once the case alertmodule 204 receives this user-initiated message, case alert module 204can determine how, when, and where to send the message based on thereceived message and intended recipient. In a similar manner, case alertmodule 204 can also receive responses to user-initiated messages andforward them to the intended computing devices. User-initiated messagesmay be sent in any suitable form and using any appropriate network. Forexample, the messages may be a text, voice, or multimedia message sentover a wired, wireless, cellular, or any other network. Thus, system 200allows medical professionals to stay apprised of real-time changes tocase information and communicate with each other efficiently to assessthe requirements of immediate patient care and coordinate effectivelywith each other.

System 200 may also interact with billing systems such as billing system112 to develop billing invoices and reports. In particular, upon requestor at defined intervals, system 200 may access practice data residing atdatabase 206 that defines report preferences for delivery ofbilling-related events. In addition, system 200 may access exportpreferences, and translation and transmission settings for placingreports in appropriate form for delivery to the billing system 112corresponding to a medical practice. Alternatively, export preferencesmay define the intended destination of bill reports or invoices. Thus,insurance companies and other responsible parties may receive a bill oran invoice developed according to their predefined report preferences.

While system 200 is illustrated as including specific components, itshould be understood that various embodiments may operate using anysuitable arrangement and collection of components.

FIG. 3 is a block diagram illustrating a mobile device 300 representingan example embodiment of mobile device 118. As illustrated, mobiledevice 300 includes a number of components that operate together tofacilitate the management of medical information. Mobile device 300 cansupport a number of different operations, including receiving practicelocation and user configuration information, case board information,patient treatment information, and case summary information forpresentation and management on a graphical user interface. In addition,mobile device 300 may facilitate case status alerting and trackingmedical cases. Mobile device 300 is further operable to facilitate themanagement of medical case assignments and roles through a graphicaluser interface. Specifically, the graphical user interface enablesassuming assignments and roles and conducting assignment androle-handoffs between users. Additionally, mobile device 300 is capableof securely accessing medical case information from a remote medicalinformation management system using appropriate authentication andsecure access techniques.

As illustrated, mobile device 300 includes a number of components formaintaining and displaying medical information. Mobile device 300 mayrepresent any suitable portable hardware, including appropriatecontrolling logic and data capable of communicating with remote devicesand systems, receiving user input, and displaying medical information.As shown, mobile device 300 includes several components, which mayinclude a network interface 302, a processor 304, a memory 306 and auser interface 308. The illustrated embodiment further discloses memory306 as including a non-volatile portion of memory 310 and a volatileportion of memory 312.

Network interface 302 represents any appropriate combination of hardwareand controlling logic for coupling to one or more networks. Networkinterface 302 may support any number of suitable protocols forcommunicating on a communication network. For example, network interface302 may be a wireless local area network interface, cellular networkinterface, satellite interface, and/or any other appropriate interfacefor communicating on a communication network. Network interface 302 mayhave multiple interfaces for handling different communication protocols.

Processor 304 represents one or more processing elements, includinghardware, logic, and data capable of controlling the operation of mobiledevice 300. For example, processor 304 may be a computer processor forexecuting a medical information management application stored in memory306, or any other software or controlling logic associated with mobiledevice 300, such as a mobile operating system.

Memory 306 represents appropriate hardware and control logic formaintaining a medical information management application and caseinformation corresponding to one or more medical practices. Memory 306may also include storage for other data, such as a mobile operatingsystem of mobile device 300. As illustrated, memory 306 includes anon-volatile portion 310 and a volatile portion 312. Non-volatileportion 310 of memory 306 represents memory for maintaining persistentapplications and/or data. Volatile portion 312 of memory 306 representsstorage for maintaining non-persistent applications and/or data.According to particular design considerations, the medical informationmanagement application and practice, location, and user configurationdata may be stored in the non-volatile portion 310 of memory 306, whilemedical professional, location, practice activity, patient data, andcase information retrieved from a medical information management systemmay be stored in the volatile portion 312 of memory 306. Such animplementation provides added security to critical data and helps toensure that confidential user, patient, and/or case information is notreadily accessible even if mobile device 300 is lost or otherwisecompromised. In some implementations, some or all of the practice,location, and user credentials may be stored in non-volatile memory tofacilitate seamless access and/or quick reentry into the system, whilesome other credential may be stored in volatile memory to ensure that alost device cannot be improperly used.

Mobile device 300 also includes a user interface 308. User interface 308represents any appropriate combination of hardware, control logic, anddata for displaying information to a user and receiving inputs from auser. Thus, user interface 308 includes any input and/or outputinterface. For example, a user interface may be a touch screen interfacethat is capable of both displaying graphical information and receivinguser inputs. User interface 308 of mobile device 300 may be used todisplay medical case information using a medical information managementapplication, and receive real-time updates of medical case informationfor appropriate processing and forwarding by the medical informationmanagement application.

In particular embodiments, mobile device 300 is capable of transmitting,receiving, and modifying medical case information to track changesoccurring in real-time at a medical facility and forward suchinformation to a medical information management system. Mobile device300 may be used by medical professionals to receive real-timeinformation corresponding to one or more cases and enter real-timeupdates for transmission to a medical information management system.Such updates, in turn, can be delivered to other computing devices orsystems. In particular embodiments, mobile device 300 must transmitupdates to medical information management system 120, which controlswhether data is actually updated. Thus, a handheld device, such asmobile device 300, enables medical case information to be managed andcoordinated between medical professionals actively rendering care to oneor more patients.

In operation, elements of mobile device 300 perform various functionsincluding facilitating maintenance and display of a graphical caseboard, enabling entry and display of medical professional activityinformation and patient treatment records having case chronologyinformation, facilitating case status alerting for tracked medicalcases, providing an intuitive graphical user interface for interactingwith the system, enabling tracking of medical case assignments and rolesin addition to handing-off assignments and roles between medicalprofessionals, and facilitating secure authentication and accesstechniques.

To provide a graphical case board, mobile device 300 retrieves andpresents information maintained by medical information management system120. For example, processor 304 may execute a medical informationmanagement application residing in a nonvolatile portion 310 of memory306 to receive medical case board information. Once this information isreceived, mobile device 300 may display a graphical case board usinguser interface 308. In operation, user interface 308 may graphicallypresent multiple predefined phases of care in multiple tabs where eachtab is selected through the user interface 308. In particularembodiments, each tab may correspond to a single predefined phase ofcare. In those embodiments, user interface 308 may receive userselections for each tab to display patient entries for patients for thecorresponding predefined phase of care. In an embodiment designed for ananesthesia practice, the predefined phases of care may correspond toschedule, pre-operation, intra-operation, and post-operation stages forproviding anesthesia care.

In some embodiments, each tab corresponding to a predefined phase ofcare may present a list of rows of patient tracking entries that listpertinent case information from a patient tracking record. This mayinclude, for example, a patient information such as the patient's name,the medical procedure, the attending physician, surgeon, oranesthesiologist, any supervising or assisting medical professional, theoperating room, scheduled operating room time, case role information,and any specific sub-events within the predefined phase of care such asthe last anesthetic or surgical event with the corresponding time.

In operation, as a patient proceeds through medical phases of care,patient tracking entries may transition from being listed under the tabfor one predefined phase of care to another. For example, in ananesthesia practice, the event of a patient arriving at a medicalfacility may cause a patient tracking entry to transition from beinglisted under a “schedule” phase to a “pre-operation” phase. Similarly,when an update indicating anesthesia administration is started for apatient, the corresponding patient tracking entry may transition from a“pre-operation stage” to an “intra-operation phase.” When an updateindicating that anesthesia administration has ended, the patienttracking entry may transition from a “intra-operation” phase a“post-operation” phase. At some predetermined point in time, such asmidnight, all post-operation cases may be clear (with potentiallyexceptions for cases completed within a set period of time nearmidnight). Thus, the functionality provided by a graphical case boardinterface can receive updates to track real-time transitions betweenphases of medical care at a defined medical practice location.

In addition, selecting a row corresponding to a patient may cause themedical information management application to retrieve either a patienttreatment record or case summary information. In one implementation, ifthe medical professional has a role associated with the case, a patienttreatment record may be presented. If the medical professional does nothave a role associated with the case, then case summary information maybe presented. Mobile device 300 can request a patient treatment recordor case summary information using network interface 302 to communicateacross the communication network to the medical information managementsystem. Mobile device 300 can also receive corresponding patienttreatment record or case summary information for display on userinterface 308 using network interface 302.

In addition to displaying the predefined phases of care for all casescorresponding to a medical practice at a defined location, mobile device300 is capable of tracking medical events corresponding to a specificpatient. In some embodiments, mobile device 300 may graphically displayeither a patient treatment record or a case summary based on whether themedical professional using this system has a role associated with thecase. A patient treatment record corresponds to a single case and mayinclude a case chronology that specifies timing of events duringtreatment. For the purposes of tracking timing and other relatedinformation, a patient treatment record may include a time record formedical events in the case chronology of the patient treatment record. Acase summary may include case details for a specific case and facilitatethe assumption or handing-off of medical roles with respect to the case.

Mobile device 300 is capable of presenting a patient treatment record ina graphical form on user interface 308. In some implementations, apatient treatment records may be presented in a tabbed interface. Forexample, a patient treatment record may be organized and displayed undermultiple selectable tabs. One tab may present information correspondingto the case in a summary form including patient and medical procedureinformation. Another tab may list a chronology of related medical eventsfor a medical procedure corresponding to the selected case based apredefined template for the medical practice. For example, listedmedical events for an anesthesia practice may include, preparation startand stop, anesthesia start and stop, antibiotic administration,intubation, and surgery start and end. Each medical event that ispresented in the chronology tab may be selected to log a timestampcorresponding to the medical event in a corresponding time record. Amongother things, the time record for each presented medical event may havea current value of time, which could be a specific time value or no timevalue at all, for example, in the case of previously unrecorded medicalevents. Logging timestamps as the new current value for a time recordpermits the proper recording of the time for a billing-related event.For example, the beginning of anesthesia may be logged by selectinganesthesia start and the end of administering anesthesia may be loggedby selecting anesthesia stop. In particular embodiments, selecting abilling-related event presents an interface for allowing the user toaccept the current time as the time value for a timestamp. Determining adifference between two such timestamps facilitate the generation ofappropriate invoices and reports for billing-related events. As changesor updates to a patient treatment record occur, corresponding changesand updates to case board information may also be triggered. Thus, otherusers can view a graphical representation of case board information,which includes information corresponding to the updated patienttreatment record.

The graphical representation of a patient treatment record may alsoinclude a tab for checklist items for recording medical events thatoccur during a medical procedure but may not have a time or durationassociated with them. Such events may include having to insert an extraintravenous line for a patient or other events that are performed for amedical procedure on an as needed basis. In addition, the checklistitems may be displayed under appropriate categories or subcategories.The order, content, number, and organization of checklist items may bedefined based on a template maintained for the practice or location at amedical information management system. Also, the tab for checklist itemsmay be pre-populated based on rules triggered by non-checklist data orother checklist items. In operation, selecting a specific checklist itemmay cause the toggling of a YES/NO indicator for specifying whether theitem has occurred during the case. Thus, the checklist presentation mayentail a summary view that facilitates checklist data review, and achecklist entry view that facilitates toggling a state (e.g. YES/NO) fora particular checklist item. In some implementations, checklist itemscan be used to ensure quality control by requiring medical professionalsto indicate whether specific policies or steps were followed. Inaddition to case specific items presented in a tabbed faun, thegraphical patient treatment interface may also include a contextualreturn tab for returning to the graphical case board. For example, thegraphical patient treatment interface may have a back tab labeledaccording to the previous screen (e.g. “Board” for the graphical caseboard), which if selected, causes the graphical case board to bedisplayed on user interface 308.

Mobile device 300 is also capable of displaying a case summary interfacefor presenting a list of relevant medical information corresponding to acase. In certain implementations, when the user selects a particularpatient tracking entry in the graphical case board interface but has norole associated with the case, the medical information managementapplication of mobile device 300 causes the user interface 308 todisplay the case summary interface. The presented case summaryinformation may include a patient identifier, the specific medicalprocedure, the attending surgeon, any anesthesiologists that aresupervising or managing the case, any procedure or diagnosis codes,specific case identifiers and any other detailed information about theselected case or patient. In addition, the information presented mayinclude relevant medical events of the case that have occurred or arecurrently taking place. In some implementations, this allows medicalprofessionals to view case details for cases for which they do not havea role but may wish to now assume a role. In those implementations,medical professionals can assess a case in summary form prior toassuming a role. Some embodiments may also include color and/or icondepictions of data incompleteness. The manner in which dataincompleteness is indicated is configurable based on location-specificrules and/or templates. Thus, the case summary interface presents avariety of relevant information to the user in an accessible form.

Some embodiments of the graphical case summary interface may alsoinclude multiple tabs. The tabs may correspond to specific roles that amedical professional can assume with respect to the case. For example,these roles may include assisting, supervising or directing, andpersonally providing care on the case. For an anesthesia practice, theseroles may correspond to responsibilities associated with theadministration of anesthesia. User interface 308 may receive a selectioncorresponding to a role, and in response, may require confirmation. Ifconfirmed, mobile device 300 may then transmit a role-handoff request tomedical information management system 120. If the information managementsystem authorizes the role-handoff, mobile device 300 may receive aconfirmation that the role assumption has occurred and, in response,present a case summary which includes the new assumed role. Inparticular implements, the graphical case summary interface may alsoinclude a contextual return tab for returning to a graphical case boardinterface. For example, a contextual return tab labeled as “Board” maybe selected using the user interface 308 for returning to a graphicalcase board interface.

Embodiments of mobile device 300 may also provide case alertingfunctionality for necessary medical professionals. As discussed, casealerts may be automatically generated or be initiated by a user. Casealerts may take on a variety of forms including voice, text, ormultimedia. For example, a user of mobile device 300 may be notifiedwhen a case that is being managed by the user of mobile device 300enters a particular predefined phase of care. As an additional example,another case alert may cause a party being relieved to be notified whena role-handoff is successfully processed. In operation, mobile device300 is capable of receiving a case alert corresponding to a case onnetwork interface 302 for processing by a medical information managementapplication being executed by a processor 304. After appropriateprocessing of the case alert, mobile device 300 may present the casealert on user interface 308 in any appropriate form. For example, mobiledevice 300 may present the case alert as a pop-up that may require theuser of mobile device 300 to acknowledge receipt of the case alert oreven take some action, such as accept a role-handoff request. In otherembodiments, the case alert may be presented in a non-intrusive formsuch as a sliding banner or a pop-up that fades away after a predefinedtime interval. In this manner, the user of mobile device 300 is informedof relevant case events corresponding to a patient undergoing a medicalprocedure at a defined location. In certain embodiments, mobile device300 may facilitate responding to case alert messages, for example, toacknowledge the receipt of the alert or to otherwise engage othermedical professionals to take appropriate action in response to theindicated case event. In those embodiments, the response may be receivedby user interface 308 and the medical information management applicationbeing executed by processor 304 may process the response for delivery toa remote medical information management system over a communicationnetwork using network interface 302. The medical information managementsystem may then process the response and forward corresponding messagesto one or more handheld devices and/or systems as appropriate.

Users of mobile device 300 may also manually initiate their own messagesfor delivery to other systems to request information related to a caseor provide information about a case to appropriate medicalprofessionals. In certain embodiments, user interface 308 may present apredefined list of user initiated messages for delivery to other medicalprofessionals corresponding to a medical practice. For example, messagesincluded in a predefined list includes but are not limited to “needbreak,” “need assistance,” “induction,” “emergency,” or other suitablepredefined message. In alternative embodiments, user interface 308 mayfacilitate the entry of user initiated messages in a free form field. Inthose embodiments, user interface 308 may facilitate the entry of fullycustomizable messages for addressing concerns with respect to a case, orany real-time need associated with a medical practice or procedure.Accordingly, mobile device 300 supports automatic and user-initiatedcase alerts for coordinating and interacting with medical professionalsassociated with a medical practice.

While mobile device 300 is illustrated as including specific components,it should be understood that various embodiments may operate using anysuitable arrangement and collection of components.

FIG. 4 is a diagram illustrating a system architecture 400 fordescribing a user interface for a medical information managementapplication operating on a handheld device. As illustrated, systemarchitecture 400 includes a collection of data review modes 402 and acollection of data entry modes 404. In general, the data review modescorrespond to display modes of the graphical user interface thatfacilitate the display of medical case board information, patienttreatment information, and case summary information. The various datareview modes 402, permit users of the system to review real-time datafor multiple concurrent cases. Data entry modes 402 represent acollection of display modes for entering case-specific information. Dataentry mode 404 enable multiple users of the medical informationmanagement system to enter data for multiple concurrent cases of amedical practice. Thus, the various display modes of system architecture400 together provide an intuitive graphical interface for data entry andretrieval for cases associated with a medical practice.

FIG. 5 is a system hierarchy 500 for a graphical user interface on ahandheld device. As illustrated, system hierarchy 500 includes a numberof modes corresponding to display modes of a graphical user interface,including a user login interface 502, a case board interface 504, a casesummary interface 506, and a patient treatment interface 508. Asillustrated, these display modes may be used to display case informationand facilitate data entry for cases in an efficient manner using thegraphical user interface at a handheld device, such as mobile device300.

System hierarchy 500 shows a first display mode having a user logininterface that first requires a device authentication. In operation,device authentication may be performed by comparing a practice or userkey code (or any other suitable identifier) to values stored in amedical information management system. Once the device itself isauthenticated, the graphical user interface may provide an interface forindicating a medical practice and selecting an authorized usercorresponding to the medical practice. Once a user is selected, thedevice may receive a password and PIN from the user. Once the user isproperly authenticated with the medical information management system,the graphical user interface may display a list of one or more supportedlocations for a medical practice. In some implementations, theselocations correspond to medical facilities for providing care topatients. In operation, the selection of a location may cause thedisplay of case board interface 504. The case board 504 providesinformation regarding all cases at a defined location organized intopredefined phases of case. The case board interface is further operableto receive a selection of a case corresponding to a particular patient.In response to receiving a selection, a case summary interface 506 orpatient treatment interface 508 may be displayed based on designconsiderations. The case summary interface 506 provides detailedinformation about a particular case, including both patient-specificinformation and current information regarding medical eventscorresponding to an ongoing or scheduled medical procedure. Inparticular implementations, a case summary interface is presented when auser is not affiliated with the case. A user may not be affiliated witha case, for example, when the user has not assumed an active role withrespect to the case.

In other implementations, selecting a particular case at the case boardinterface 504 causes the graphical user interface to proceed to apatient treatment interface 508. According to design considerations,patient treatment interface 508 may be presented if the user using thegraphical user interface actually has an active role in the selectedcase. For example, as shown in the illustration, a patient treatmentinterface 508 may present a patient treatment record in three differentdisplay modes. One mode may present patient and case information in sucha manner that facilitates modification of specific data elements.Another display mode may display case chronology and facilitate thetracking of medical events for the case in corresponding time records.Another display mode of patient treatment interface 508 may permit therecording of case data items corresponding to medical events or itemsnot having a time or duration associated with them. Such case items maybe listed in a checklist form. In some embodiments, checklist items mayinclude case items for ensuring quality control or conformity withinstitutional policies for a medical practice. Thus, the hierarchy ofdisplay modes of system hierarchy 500 facilitate streamlined access tomedical case information in an aggregate form through case boardinterface 504, and the real-time tracking of specific cases throughpatient treatment interface 508.

FIG. 6 is a diagram illustrating a case board 600 representing anexample graphical case board interface for a handheld device interactingwith a system according to the present disclosure. As shown, case board600 includes various elements that together provide a distinctiveinterface for interacting with the graphical case board. In theillustrated embodiment, case board 600 includes two elements: case boardtabs 602 and multiple patient tracking entries 604. Among the patienttracking entries 604 is a user-affiliated patient tracking entry 606.The displayed user interface, organization of patient entries and phasesof care, color and other visual schemes, level of detail, and otherinformation displayed by case board 600 may be customized based on theparticular user, practice group associated with the user, location atwhich the user is working, or other appropriate settings and data. Inaddition, some embodiments may also include color and/or icon depictionof data incompleteness. The manner in which data incompleteness isindicated is also configurable based on location-specific rules and/ortemplates.

As illustrated, case board tabs 602 of case board 600 represent anorganization of patient tracking entries according to predefined phasesof care corresponding to a medical practice at a defined location. Thesepredefined phases of care may be defined in a template configured for amedical practice and maintained by a central medical informationmanagement system. In the illustrated embodiment, each of the case boardtabs 602 correspond to a phase of providing anesthesia care. Forexample, the “schedule” phase corresponds to a phase of providingmedical care where each of the patients listed are scheduled but havenot yet arrived in the peri-operative area. Another phase, an anesthesiapre-operation phase shown in the illustration as “pre-op,” represents aphase of care prior to an anesthetic (or surgical) procedure wherepatients are waiting in the surgical holding room or pre-operation area.The next tab corresponds to an intra-operation phase shown in theillustrated embodiment as “intra-op.” The intra-operation phaserepresents a phase of care wherein the patients have in-processanesthetics or are in the operating room. Finally, the last tabcorresponds to a post-operation anesthesia phase, shown in the figure as“post-op.” This final stage corresponds to a phase of care after theanesthetic (or surgical) procedure where the patients are in thesurgical recovery room or post-operation area.

In operation, each of the illustrated tabs may be selected to listpatient tracking entries corresponding to that phase. For example, inthe illustrated embodiment, “intra-op” is currently selected andcorresponding patient tracking entries 604 are displayed. Case boardtabs 602 may also indicate case count information as shown by thenumbers below each labeled tab for a predefined phase of care. Thesenumbers allow a user presented with case board 600 to determine, at aquick glance, how many patient tracking entries can be found under eachof the case board tabs 602. In certain implementations, the case countmay correspond to the number of cases under each of the case board tabs602 that correspond to the user. For example, the case count may be thetotal number of cases within a predefined phase of care for which theuser has a case role. Thus, the case board tabs 602 provide auser-friendly organization of patients as they proceed throughpredefined phases of anesthesia care.

As specific patients associated with the patient tracking entriesprogress from one predefined stage to another, case board 600 may beupdated with appropriate listings under the corresponding case boardtabs 602, potentially in real-time as these changes occur in the field.For example, when a user of a particular mobile device 118 provides apatient treatment update indicating that a patient has begun receivinganesthesia, and medical information management system 120 transitionsthat patient from a pre-operation stage to an intra-operation stage, andall mobile devices 118 tracking that patient or that patient's surgicallocation can be updated. Accordingly, the corresponding patient trackingentry transitions from being listed under the illustrated “pre-op” tabto being listed under the illustrated “intra-op” tab. The case countinformation corresponding to the tabs may also be updated to reflectsuch transitions.

The illustrated embodiment of case board 600 shows multiple patienttracking entries 604. Each patient tracking entry of patient trackingentries 604 corresponds to a particular predefined phase of careindicated by the appropriate case board tab. As illustrated, multiplepatient tracking entries 604 are listed for the intra-operation phase ofanesthesia care. In particular, each patient tracking entry has specificinformation corresponding to the indicated case. For example, as theillustration shows, the patient tracking entry may include patientinformation such as the patient's name, the medical procedure, theassigned operating room, the attending surgeon/physician, theanesthesiologist and any supervising anesthesiologist, and sub-eventswithin the predefined phase of care such as surgery start, entering anoperating room, or an antibiotic being administered. In addition, eachof these sub-events may include a timestamp indicating when thesub-event occurred. In particular embodiments, case board 600 maydisplay icon-based depictions of specific medical events or status for agiven case.

The illustration also shows a user-affiliated patient tracking entry 606of patient tracking entries 604. In particular embodiments, case board600 may cause the list of patient tracking entries 604 to be sortedwhere cases affiliated with the user are brought to the top of the list.For example, user-affiliated patient tracking entry 606 is shown at thetop of the list of patient tracking entry 604 because it is affiliatedwith the user of the handheld device on which case board 600 is beingdisplayed. A user affiliation, for example, may be established when theuser of case board 600 has a particular role with respect to theindicated case. Also, as shown in the illustration, user-affiliatedpatient tracking entry 606 may be highlighted using color or some othersuitable visual emphasis. In addition to distinguishing theuser-affiliated patient tracking entry 606 from other patient trackingentries, the provided visual emphasis may further indicate the nature ofthe role that the user of case board 600 has with respect to the patientindicated by the patient tracking entry. For example, case board 600 mayuse a color scheme defined for the practice where one color indicatesthat the user is in a supervisory role and another color indicates thatthe user is actively providing care for a case identified by the patienttracking entry. While a color scheme is disclosed by this particularillustration, any suitable visual emphasis for separatinguser-affiliated patient tracking entries from other patient trackingentries is envisioned by the present disclosure. The informationdisplayed in the rows corresponding to user-affiliated patient trackingentries, such as user-affiliated patient tracking entry 606, may befurther based on the user's case role. For example, a user-affiliatedpatient tracking entry where the user is in a supervisory role mayresult in particular information being displayed in a particular format.Another user-affiliated patient tracking entry where the user isactively providing care, for example, may result in other informationbeing displayed and/or another information format being used. Theillustrated embodiment also indicates that case board 600 relies onreceiving case status and event data from a remote medical informationmanagement system which is updated in real-time by multiple medicalprofessionals actively engaged in patient care at a practice location.

In operation, each of the patient tracking entries 604, includinguser-affiliated patient tracking entry 606 are capable of being selectedthrough a user interface. The selection of one of the patient trackingentries 604 may result in either a case summary or patient treatmentinterface being displayed. Design considerations may dictate which oneof these interfaces is displayed. For example, in the illustratedembodiment, selecting user-affiliated patient tracking entry 606 mayresult in the patient treatment interface being displayed since the userof case board 600 has a specific role with respect to theuser-affiliated patient tracking entry 606. If one of the other patienttracking entries are selected, a case summary interface is displayed. Acase summary interface lists details about a particular case includingrelevant medical events and specific medical data corresponding to thepatient (e.g. patient identification and medical history). In certainimplementations, the case board 600 may be visually distinguished from apatient treatment and/or case summary interface. For example, the caseboard may be monochromatic while the patient treatment interface and/orcase summary interface may use colorful tabs or menu selections. Caseboard 600 may also be operable to receive a user request for a refreshof the case board information. For example, shaking the device maygenerate a case board refresh request that causes case board 600 tofetch updated case board information from a remote medical informationmanagement system for display on the graphical case board interface.Thus, case board 600 provides a user-friendly interface for tracking allmedical cases for a medical practice at a particular location.

FIG. 7 is a diagram illustrating an example patient treatment interface700 for displaying a patient treatment record for an active case at amedical practice. As described, the patient treatment interface 700 maybe displayed when a graphical user interface of a handheld devicepresenting a case board 600 receives a user selection corresponding to aspecific patient tracking entry. The displayed user interface,organization of case and checklist items, specific medical events,color, icons and other visual schemes, the level of information detail,and other information displayed by patient treatment interface 700 maybe defined by a template configured for a medical practice andmaintained remotely by a medical information management system. Forexample, some embodiments may also include color and/or icon depictionof data incompleteness. The manner in which data incompleteness isindicated is configurable based on location-specific rules and/ortemplates. The illustrated embodiment shows patient treatment interface700 as including patient treatment tabs 702 and case chronology events704 corresponding to a chronology of medical events for a particularcase at a medical facility. Unlike checklist items, these medical eventstypically have or will have a time value or duration associated withthem. Among the case chronology events 704, is an antibioticadministration event 706 shown as the last recorded medical event.

Patient treatment tab 702 of patient treatment interface 700 provides atabbed interface for displaying case specific information. In theillustrated embodiment, patient treatment tab 702 includes four tabs.While the first tab facilitates return to the graphical case board 600,the other tabs provide further details for the selected case. Forexample, the information tab provides detailed information about thepatient, such as medical history and other identifying data along withrelevant medical events corresponding to the medical care beingprovided. Another tab, shown as the checklist tab, lists specific caseitems in a checklist format. These items correspond to medical eventsthat may be necessary on an as needed basis during a medical procedurebut do not have a time or duration associated with them. Thus, forexample, an anesthesiologist may record a medical event that becamenecessary for a particular patient, such as starting an extraintravenous line, which may not include a time value or duration. Othercase items may relate to quality control measures or institutionalpolicies enforced by a medical practice. Finally, the selectedchronology tab displays medical events for a particular medicalprocedure shown in the illustrated embodiment as case chronology events704. As shown, the case chronology events have timing associated withthem, which may be recording in an appropriate time record. Further,patient treatment tabs 702 may be visually distinguished from each otherto discern one tabbed display mode from another.

In the illustration, the chronology tab of patient treatment tabs 702 isselected. The chronology tab displays multiple case chronology events704. Each of these case chronology events corresponds to an medicalevent for the medical procedure corresponding to the selected patientand may have an associated time record for recording a time value orduration. The medical events that are listed under the chronology tabmay be defined by a practice and/or location-specific templatemaintained by a medical information management system. For example, asthe illustration shows, these events may include prep start, prep stop,anesthesia start, operating room (OR) enter, antibiotic admin,intubation, surgery start, surgery end, and OR exit. Other events mayinclude, arrival in the holding room, anesthesia stop, bypassstart/stop, heart stop/start, C-section start/stop, vaginal deliverystart/stop. Case chronology events 704 may be visually nested to definerelationships between collections of events. For example, all casechronology events between OR enter and OR exit are considered part of anoperating room event. This relationship is shown by the indentation ofassociated sub-events relative to the case chronology events that theyare considered to be part of. For example, antibiotic admin, intubation,surgery start and surgery end rows are indented in relation to OR enterand OR exit to show that those events are to take place between entryand exit of the operating room. Patient treatment interface 700 alsoillustrates nested relationships and the relative duration of medicalevents by visually emphasizing the range of medical events usingcolor-coded vertical bars in the left margin. The colors or other visualemphasis for the vertical bars may be configured in a practice templatemaintained by a medical information management system. In certainimplementations, some of the case chronology events 704 may facilitatevisual reordering of medical events based on location or practice rules.At the same time, certain case chronology events 704 may not facilitatevisual reordering if the location or practice rules prohibit it.

In operation, the rows corresponding to each of the case chronologyevents 704 are operable to receive a user selection through a userinterface to cause the patient treatment interface 700 to record atimestamp corresponding to the appropriate case chronology event. Thistimestamp may be recorded in a time record corresponding to the event.For example, when a row corresponding to one of the case chronologyevents 704 is selected, patient treatment interface 700 may present abutton enabling rapid entry of the current time as the timestamp for theselected case chronology event or present another interface, whichallows the user to enter another time for the selected case chronologyevent. As shown, the last recorded event in the illustrated embodimentis “antibiotic admin” at time 13:20, which was recorded by selecting thearrow shown in the right margin of the row corresponding to antibioticadministration event 706. This time value may be recorded as the currentvalue for the time record corresponding to antibiotic administrationevent 706. Other events such as intubation, surgery start and surgeryend, and OR exit may be recorded in a similar fashion as the medicalprocedure progresses. Since these other events are unrecorded, theircorresponding time records would have no current value at all. Inoperation, the patient treatment interface 700 is operable through thechronology tab to respond to the receipt of a user selection of one ofthe case chronology events 704, such as, for example, the antibioticadministration event 706, record a timestamp in the appropriate timingrecord and send an event update corresponding to the selected medicalevent over a network to central medical information management system.In this manner, other computing devices and systems managing caseinformation can receive and review changes to case chronology events ofa patient tracking record in real-time, including update of the lastcase event parameter on case board 600. In some implementations, patienttreatment interface 700 may permit a medical professional to add newmedical events using the graphical user interface. For example,selecting a specialty row for adding events may allow a user to define anew medical event for medical tracking purposes.

Some embodiments of patient treatment interface 700 may implement otherfeatures. For example, some of the case chronology events 704 mayfacilitate the reversal of a medical event recording. For example,selecting particular events may allow user to undo the recording of anevent. This may be useful to correct user entry errors, or for othermedical reasons. Based on design considerations, certain medical eventsmay be irreversible as defined by the associated medical practice. Forexample, a particular medical practice may not choose to allow medicalprofessionals rendering anesthesia care to undo the event of anesthesiastart. Some embodiments may display a countdown timer for indicating thetime remaining for a medical procedure, and this information may betransmitted in real-time to a medical information management system. Asyet another feature, the patient treatment interface 700 may also beoperable to receive a user request for a refresh of the patienttreatment information. For example, shaking the device may generate arefresh request for a patient treatment record that causes patienttreatment interface 700 to retrieve updated patient treatmentinformation from a remote medical information management system fordisplay on the graphical case board interface. Thus, patient treatmentinterface 700 provides an user-friendly interface for tracking andrecording medical events in real-time.

FIG. 8 is a block diagram illustrating a case alert system 800 withelements that interoperate to receive, process, and transmit case alertsto various users of a medical information management system. Theelements of case alert system 800 can support a number of operationsassociated with generating and sending case alerts, includingconfiguring alert event triggers for maintenance by a central case alertsystem processing, processing real-time medical events for comparisonwith alert event triggers to determine whether to issue a case alert,and formatting and transmitting case alert messages for delivery onvarious networks using disparate protocols. Various example networks forsending alerts include a wired/wireless computer network, pagernetworks, cellular SMS networks, email networks, and instant-messagingnetworks.

In the illustrated embodiment, case alert system 800 includes a numberof elements that work together to alert one or more medicalprofessionals. As shown, case alert system 800 includes an event triggerconfiguration interface 802, a case alert manager 804, and one or moreintended recipients 806. Some or all of the functionality of system 800may be provided by case alert module 204. As a particular example, thefunctionality of case manager 804 may be implemented in case alertmodule 204 of system 200.

Event trigger configuration interface 802 represents any suitableinterface for configuring medical events for which a case alert shouldbe issued to one or more intended recipients 806. For example, an eventtrigger configuration interface 802 may be a web interface for supplyinga case alert manager 804 with specific event triggers. In addition, theevent trigger configuration interface 802 may couple to an appropriatecommunication network to transmit event trigger configurations to casealert manager 804 for updating an appropriate database.

Case alert manager 804 represents appropriate hardware, control logic,and data for storing case alert configurations and determining when andhow to issue an alert according to the configured event triggers. Forexample, case alert manager 804 may be a computer server or virtualcomputer server capable of processing case alerts. In certainimplementations, case alert manager may be embodied in a module of alarger medical information management system, such as case alert module204 of system 200.

Intended recipients 806 represent one or more medical professionals of amedical practice or surgical location indentified in an event triggerfor receiving case alerts on the occurrence of predefined medicalevents. For example, as shown, the intended recipients may include anurse, a case board runner, an anesthesiologist, or a CRNA. The actualalert method used to notify intended recipients 806 may conform to anyappropriate protocol on any suitable network. For instance, a medicalprofessional may receive case alerts in a text message using an SMSservice or in an email using a wired/wireless network.

In operation, the case alert manager 804 may issue a case alert to oneor more intended recipients 806 when a real-time medical event matchesan event in a stored event trigger configured through an event triggerconfiguration interface 802. In particular, case alert manager 804receives one or more event triggers through the event triggerconfiguration interface 802 for storage in an appropriate database.Next, case alert manager 804 monitors medical events for one or morecases in a medical practice. For example, case alert manager 804 maymonitor updates to a central database maintaining case informationtracking patients receiving care. Case alert manager 804 may thenprocess these medical events to determine whether the identified medicalevents match the events in any stored event triggers. If a match isfound, case alert manager 804 may issue a proper case alert message inan appropriate format and using a suitable network to notify one or moreindicated intended recipients 806. Accordingly, embodiments of thepresent disclosure can receive, process, and send case alerts tofacilitate coordination of medical activities for one or more cases.

FIG. 9 is a process flow diagram illustrating a process flow 900 forsecure user authentication, login, and access to a medical informationmanagement system. The steps of process flow 900 correspond to anexample sequence of steps for securely accessing medical informationfrom a medical information management system. Such an authenticationprocess ensures that confidential patient information and medical caseinformation are protected from unwanted disclosure. A userauthentication process like process flow 900 may be implemented on thefront-end of medical information management system such that access tofeatures, functionality, and confidential information require users tobe first authenticated by the system.

In the illustration, process flow 900 includes a number of steps forproviding user authentication, login, and access to a medicalinformation management system. As shown, these steps include a deviceauthorization step 902, a user selection step 904, a user authorizationstep 906, a location selection step 908, a user login step 910 and acase board presentation step 912. This collections of steps may beperformed, for example, on a handheld device, such as mobile device 300,through a graphical user interface interacting with a remote medicalinformation management system.

The illustration also shows an authentication system 914 and an exampleuser login interface 916. Authentication system 914 represents a systemfor authenticating and facilitating access users of the system. Forexample, authentication system 914 may be embodied in a larger medicalinformation management system, such as system 200. The authenticationsystem may be configured with users and locations through an appropriateconfiguration interface. For example, a web interface may be used toconfigure authentication system 914 with users and locations havingaccess to the system. User login interface 916 represents an exampleuser login interface for supplying a PIN to the authentication system914.

In operation, process flow 900 begins at the device authorization step902. In this step, the user of a handled device supplies a practice keyidentifying a particular medical practice or a user key identifying auser within a particular medical practice. This information is sentacross a network via path 1A along with a device hash corresponding tothe authentication system 914. The device hash ensures that onlyauthorized devices may access the system, thereby providing a firstlevel of access protection to the system. Once the practice key or userkey and device hash are determined to be valid by authentication system914, the system responds by sending two lists via path 1B over one ormore networks to the handheld device: a list of authorized users for theidentified medical practice and a list of specific practice locationsfor the medical practice.

Next, the graphical user interface of the handheld device proceeds tothe user selection step 904. At this step the graphical user interfacemay be used to indicate one of the authorized users in the list suppliedby authentication system 914. Process flow 900 then enters the userauthentication step 906 where the graphical user interface may receive apassword for the selected authorized user. Requiring the selection of anauthorized user and corresponding password provides a second level ofaccess protection to the system. User authentication step 906 maytransmit this information over one or more networks to theauthentication system 914 for validation, shown as path 3A of theillustration. Once the authentication system confirms that the passwordis valid, the authentication system sends a personal identificationnumber (PIN) over a network through return path 3B to the handhelddevice. This PIN corresponds to the medical practice and the useridentified from the authorized list of users delivered to the handhelddevice following device authorization step 902. Process flow 900 thenproceeds to the location selection step 908 where a selection of aparticular practice location associated with the medical practice isreceived by the graphical user interface. This causes process flow 900to enter a user login step 910.

In operation, user login step 910 may present an appropriate user logininterface such as, for example, the illustrated user login interface916. The user login interface may accept a user-supplied PIN using thegraphical user interface. Requiring a user PIN specific to the selectedauthorized user provides a third level of access protection to thesystem. Once this information is received, user login step 910 mayvalidate the user-supplied PIN against the PIN received fromauthentication system 914 following user authentication step 906. Avalidated PIN can be used again later after validation for quick accessto medical information and functionality provided by the system, therebyobviating repeated validations of the practice key or user key andpassword corresponding to the selected authorized user. Finally, if theentered PIN is valid, process flow 900 proceeds to a case boardpresentation step 912.

In the illustrated embodiment, entering case board presentation step 912indicates that all proper authentication steps for accessing the medicalinformation management system have been properly processed and thataccess to the system has been granted. Thus, in the case boardpresentation step 912, the graphical user interface may display anappropriate interface for interacting with a medical informationmanagement system. Such an interface may include a graphical case boardinterface for performing various case-related functions corresponding tothe selected medical practice and location. Some embodiments may supportthe retention of selected authorized user and location information forrapid system re-entry which may require a subset of the originalauthentication information as user input. Similarly, in someimplementations where there are more than one locations associated withpractice, entering another practice location may only require anappropriate subset of the original authentication information as userinput. For example, a graphical user interface may request entry of auser PIN to regain access to information and functionality supplied by apreviously accessed medical information management system, or to switchpractice locations. Thus, process flow 900 describes an example sequenceof steps for user authentication, login, and access to a medicalinformation management system.

While process flow 900 is illustrated as including specific steps, itshould be understood that various embodiments may implement a userauthentication login and access scheme using any appropriate combinationof steps for providing secure access to a medical information managementsystem.

FIG. 10 is a process flow diagram illustrating an example process flow1000 for conducting role-handoffs between medical professionalsassociated with a medical practice or an anesthesia care location. Asillustrated, process flow 1000 includes a case role selection step 1002,role-handoff confirmation step 1004, a case role confirmation step 1006,a role assumption step 1008, and a patient treatment interface step1010. Various steps in process flow 1000 interact with other systems andinterfaces. For example, the steps of process flow 1000 may interactwith a user and location configuration interface 1014 and a case rolemanagement system 1016. An example role-handoff confirmation message1020 for confirming a selected role-handoff is also illustrated.

Case role management system 1016 represents a system for managing casesand case role assignments at an anesthesia care location. For example,case role management system 1016 may be embodied as an element orcombination of appropriate elements of a medical information managementsystem, such as system 200. Thus, for example, case role managementsystem 1016, may be implemented by business logic 210 of system 200. Auser location configuration interface 1014 represents any appropriateinterface for configuring assignments and case roles and communicatingsuch configuration to a case role management system 1016. For example, auser location configuration interface may be web interface forconfiguring case roles over a network to case role management system1016.

In operation, the illustrated process flow 1000 begins at the case roleselection step 1002. As discussed, a role indicates a responsibility ofmedical professionals associated with a medical case. In case selectionstep 1002, a graphical user interface at a handheld device, such assystem 300, permits a medical professional to select a case role. Thesecase roles may be presented, for example, in a case summary interfacedescribing a particular medical case. In certain embodiments, a tab ofthe case summary interface may receive a role selection for the case.For example, a user may select one of many tabs corresponding anassisting role, a supervisory or directing role, or a care providerrole.

As shown in process flow 1000, once a case role is selected, case roleselection step 1002 may proceed to an optional role-handoff confirmationstep 1004. At this optional step, the graphical user interface mayrequest confirmation of a role-handoff request when another medicalprofessional currently has that role. This optional step thus confirms amedical professional's desire to relieve another medical professionalwho is already acting in that particular role with regard to a case. Forexample, a graphical user interface may present a role-handoffconfirmation message 1020 to seek confirmation of a role-handoff fromone specific medical professional to another. Thus, the optionrole-handoff confirmation step 1004 ensures that a role-handoff was notinadvertently requested.

In operation, the case role confirmation step 1006 is entered from thecase role selection step 1002 or the optional role-handoff confirmationstep 1004, as shown in the illustrated process flow 1000. In the caserole confirmation step 1006, the graphical user interface seeks aconfirmation from the user that a case role assumption is requested. Forexample, a graphical user interface may present a pop-up panel thatappears momentarily on the screen for confirming a case role selectionor handoff. Once confirmed, case role confirmation step 1006communicates over one or more networks through the shown path 2A with acase role management system 1016, which may be configured by userlocation configuration interface 1014. As process 1000 further shows,case role management system 1016, after receiving a confirmed case rolerequest responds over one or more networks via path 2B to a handhelddevice.

Process flow 1000 then proceeds to role assumption step 1008. Roleassumption step 1008 accepts confirmation of a successful roleassumption or role-handoff and updates the graphical user interfaceaccordingly. As shown by process 1000, role assumption step 1008 can,for example, transition the graphical user interface to presenting acase information interface at patient treatment interface step 1010.Patient treatment interface step 1010 presents further details about thecase for which the user of a handheld device now holds an assumed role.Among other things, this interface facilitates retrieval and real-timemanagement of case information. In some embodiments, case rolemanagement system 1016 is further capable of logging the timecorresponding to a role assumption or role-handoff. Recording suchtimestamps enables medical professionals associated with the case todetermine all medical professionals who were and are currently involvedwith a case. This information can also be used to generate appropriateinvoices and billing reports for a medical practice. In certainimplementations, appropriate medical professionals may be notified, suchas by a case alert, based on predefined event triggers or rulesmaintained by a medical information management system.

FIG. 11 illustrates an example case summary interface 1100 forsummarizing case details and facilitating role-handoffs. Case detailsmay include details about a patient such as identifying information,medical history, and past and ongoing medical events corresponding to amedical procedure being conducted on the identified patient. The casesummary interface 1100 also facilitates the assumption of roles bymedical professionals or role-handoffs between medical professionals.Thus, for example, the shown case summary interface 1100 may implementthe process flow 1000 for assuming roles and conducting role-handoffs.In particular implementations, case summary interface 1100 may bepresented when a user selection of a particular patient tracking entrycorresponding to a case is received at a graphical case board interfaceand the user does not already have a role associated with the case.

As shown in the illustrated embodiment, case summary interface 1100includes case summary tabs 1102 and a case details list 1104. Thesecomponents of case summary interface 1100 facilitate quick data reviewof a case and also enable assumption of roles and role-handoffs. Asshown, case summary tabs 1102 include a number of tabs for interactingwith case summary interface 1100. For example, as shown, a contextualreturn tab may receive a user selection to return to a graphical caseboard interface. In addition, other shown tabs such as the preparationor assist tab, the supervise or direct tab, and the provide care tab mayreceive selections through a user interface for assuming a role orhanding-off roles between medical professionals. Case details list 1104displays specific information corresponding to the case in list form,including patient information and medical history. Case details list1104 may also present a sequence of medical events corresponding toevents that have occurred with respect to a case and any otherinformational items relevant to the case.

While case summary interface 1100 is demonstrated as including specificcomponents and displaying particular information, it should beunderstood that various embodiments may operate using any suitablearrangement and collection of components having any appropriate displayformat and such arrangements and components may be configurable by aparticular medical practice or anesthesia care location.

Although the present disclosure describes several embodiments, it shouldbe understood that a myriad of changes, substitutions, and alterationscan be made without departing from the spirit and scope of the inventionas defined by the appended claims.

1. A handheld apparatus comprising: a user interface comprising adisplay and capable of receiving user input; a wireless networkinterface capable of coupling to a central medical informationmanagement system, the central medical information management systemmaintaining a plurality of patient tracking records for patientsreceiving care, wherein each of the patient tracking records includes apatient identifier, medical personnel assignments indicating, for thosepatient tracking records with assigned personnel, one or more assignedmedical providers and, for each assigned medical provider, one of aplurality of caregiver roles, and case status information indicating acurrent state of the care for the patient; a memory maintaining amedical information management application and a user profile comprisinga user identifier; a processor operable, when executing the medicalinformation management application: to display a list of the patienttracking records received from the medical information managementsystem; to identify a selected one of the patient tracking records basedon user input; to display indications of at least one of the caregiverroles; to receive a role selection for the selected patient trackingrecord based on user input, the role selection indicating a desire toassume one of the caregiver roles for the selected patient trackingrecord; to communicate the role selection and the user identifier to themedical information management system; and to receive an informationupdate from the medical information management system, the informationupdate reflecting that the medical information management system hasupdated the assigned medical providers for the selected patient trackingentry to reflect the role selection.
 2. The apparatus of claim 1,wherein the processor is further operable, when executing the medicalinformation management application, to receive the selected patienttracking record from the medical information management system; and todisplay a case summary screen showing detailed patient and caseinformation in the selected patient tracking record and the indicationsof at least one of the caregiver roles.
 3. The apparatus of claim 1,wherein the processor is further operable, when executing the medicalinformation management application, to display a confirmation messagefor the role selection based on whether the role is currently held by anassigned medical provider; to receive a confirmation for the roleselection as user input; and to communicate the role selection and theuser identifier to the medical information management system based onthe received confirmation.
 4. The apparatus of claim 1, wherein theindications of at least one of the caregiver roles include indicationsof the caregiver roles based on a user identifier.
 5. The apparatus ofclaim 1, wherein if the medical personnel assignments for the selectedpatient treatment record indicates a currently assigned medicalprovider, the role selection triggers a confirmation message to thecurrently assigned medical provider requesting approval for the roleselection.
 6. The apparatus of claim 1, wherein if the medical personnelassignments for the selected patient treatment record indicates acurrently assigned medical provider, the role selection triggers analert message to the currently assigned medical provider.
 7. Theapparatus of claim 1, wherein the processor is further operable, whenexecuting the medical information management application, to receive amessage indicating that the role selection violates role handoff rulesmaintained by the medical information management system and to display amessage indicating failure of the role selection.
 8. The apparatus ofclaim 7, wherein the rules prohibit providing care in more than a firstpredetermined number of cases involving the administration ofanesthesia, prohibit supervising more than a second predetermined numberof cases involving the administration of anesthesia; and prohibitassisting more than a third predetermined number of cases involving theadministration of anesthesia.
 9. A method comprising: displaying a listof patient tracking records received from a medical informationmanagement system, the central medical information management systemmaintaining a plurality of patient tracking records for patientsreceiving care, wherein each of the patient tracking records includes apatient identifier, medical personnel assignments indicating, for thosepatient tracking records with assigned personnel, one or more assignedmedical providers and, for each assigned medical provider, one of aplurality of caregiver roles, and case status information indicating acurrent state of the care for the patient; identifying a selected one ofthe patient tracking records based on a user input; displayingindications of at least one of the caregiver roles; receiving a roleselection for the selected patient tracking record based on user input,the role selection indicating a desire to assume one of the caregiverroles for the selected patient tracking record; communicating the roleselection and the user identifier to the medical information managementsystem; and receiving an information update from the medical informationmanagement system, the information update reflecting that the medicalinformation management system has updated the assigned medical providersfor the selected patient tracking entry to reflect the role selection.10. The method of claim 9, further comprising receiving the selectedpatient tracking record from the medical information management system;and displaying a case summary screen showing detailed patient and caseinformation in the selected patient tracking record and the indicationsof at least one of the caregiver roles.
 11. The method of claim 9,further comprising displaying a confirmation message for the roleselection based on whether the role is currently held by an assignedmedical provider; receiving a confirmation for the role selection asuser input; and communicating the role selection and the user identifierto the medical information management system based on the receivedconfirmation.
 12. The method of claim 9, wherein the indications of atleast one of the caregiver roles include indications of the caregiverroles based on a user identifier.
 13. The method of claim 9, wherein ifthe medical personnel assignments for the selected patient treatmentrecord indicates a currently assigned medical provider, the roleselection triggers a confirmation message to the currently assignedmedical provider requesting approval for the role selection.
 14. Themethod of claim 9, wherein if the medical personnel assignments for theselected patient treatment record indicates a currently assigned medicalprovider, the role selection triggers an alert message to the currentlyassigned medical provider.
 15. The method of claim 9, further comprisingreceiving a message indicating that the role selection violates rolehandoff rules maintained by the medical information management systemand to display a message indicating failure of the role selection. 16.The method of claim 15, wherein the rules prohibit providing care inmore than a first predetermined number of cases involving theadministration of anesthesia, prohibit supervising more than a secondpredetermined number of cases involving the administration ofanesthesia; and prohibit assisting more than a third predeterminednumber of cases involving the administration of anesthesia.
 17. Asystem, comprising: a central medical information management systemoperable to maintain a plurality of patient tracking records forpatients receiving care, wherein each of the patient tracking recordsincludes a patient identifier, medical personnel assignments indicating,for those patient tracking records with assigned personnel, one or moreassigned medical providers and, for each assigned medical provider, oneof a plurality of caregiver roles, and case status informationindicating a current state of the care for the patient; one or moremedical information management applications each residing on a wirelesshandheld device and operable, when executed, to: display a list of thepatient tracking records received from the medical informationmanagement system; identify a selected one of the patient trackingrecords based on user input; display indications of at least one of thecaregiver roles; receive a role selection for the selected patienttracking record based on a user input, the role selection indicating adesire to assume one of the caregiver roles for the selected patienttracking record; communicate the role selection and the user identifierto the medical information management system; and receive an informationupdate from the medical information management system, the informationupdate reflecting that the medical information management system hasupdated the assigned medical providers for the selected patient trackingentry to reflect the role selection.
 18. The system of claim 17, whereinthe one or more medical information management applications areoperable, when executed, to receive the selected patient tracking recordfrom the medical information management system; and to display a casesummary screen showing detailed patient and case information in theselected patient tracking record and the indications of at least one ofthe caregiver roles.
 19. The system of claim 17, wherein the one or moremedical information management applications are operable, when executed,to display a confirmation message for the role selection based onwhether the role is currently held by an assigned medical provider; toreceive a confirmation for the role selection as user input; and tocommunicate the role selection and the user identifier to the medicalinformation management system based on the received confirmation. 20.The system of claim 17, wherein the indications of at least one of thecaregiver roles include indications of the caregiver roles based on auser identifier.
 21. The system of claim 17, wherein if the medicalpersonnel assignments for the selected patient treatment recordindicates a currently assigned medical provider, the role selectiontriggers a confirmation message to the currently assigned medicalprovider requesting approval for the role selection.
 22. The system ofclaim 17, wherein if the medical personnel assignments for the selectedpatient treatment record indicates a currently assigned medicalprovider, the role selection triggers an alert message to the currentlyassigned medical provider.
 23. The system of claim 17, wherein the oneor more medical information management applications are operable, whenexecuted, to receive a message indicating that the role selectionviolates role handoff rules maintained by the medical informationmanagement system and to display a message indicating failure of therole selection.
 24. The system of claim 23, wherein the rules prohibitproviding care in more than a first predetermined number of casesinvolving the administration of anesthesia, prohibit supervising morethan a second predetermined number of cases involving the administrationof anesthesia; and prohibit assisting more than a third predeterminednumber of cases involving the administration of anesthesia.